2012-05-10 / News

Island doc discusses dangers of high-cholesterol medicine

Dr. Barbara Roberts’ new book examines the dangers of drugs known as statins

DR. BARBARA ROBERTS DR. BARBARA ROBERTS A Brown University medical professor is warning the public about high-cholesterol medicines, known as statins. According to Jamestown resident Dr. Barbara Roberts, doctors frequently prescribe statins to patients with high cholesterol to lower their risk of heart attack, but these drugs often have serious side effects and may not, in reality, prevent heart attacks or death.

As an alternative, she advocates the Mediterranean diet, as it existed in Crete, Sicily and southern Italy during the 1950s, before the arrival of McDonald’s.

“Statins confer small reductions in the risk of heart attacks and dying of heart attacks,” she said, “but only for men and not for women. The Mediterranean diet is just as good at lowering inflammatory markers.”

She added, “And it tastes good, too.”

Roberts said the diet of whole grains, olive oil, colorful vegetables and fruits, fish, eggs and poultry has been shown to reduce heart disease and cancer. Surprisingly, 45 percent of that Mediterranean diet was fat, but all the fat came from olive oil – not from sweets or from red meat.

Roberts, who is director of the Women’s Cardiac Center at Providence’s Miriam Hospital, moved to Jamestown with her husband in 1998. She recently finished a book titled “The Truth about Statins: Risks and Alternatives to Cholesterol Lowering Drugs.”

Last week Roberts presented serious criticism of statins, which she defined as a “class of medicines that lower cholesterol,” at a forum at the Jamestown Philomenian Library. More than 100 people packed the meeting hall to hear her speak, and several of them said they have been prescribed statins.

Roberts, who is an American College of Cardiology fellow, told the crowd that statins do lower cholesterol, but their benefits have been “exaggerated and the risks downplayed.”

Regarding the drug benefits, medical studies routinely claim that statins prevent heart attacks and death in 50 percent of patients. But she said that the percentage is misleading because people do not understand the terminology or know the differences between absolute risk, relative risk and the “number needed to treat.” The 50 percent number represents relative risk, but the actual number of patients who have avoided heart attack, stroke or death by taking statins is almost negligible.

Meanwhile, the side effects “are becoming more and more apparent.” They include diabetes, memory loss and muscle pain, according to the U.S. Food and Drug Administration’s February warning.

One risk that can be caused by statins is rhabdomyolysis, which Roberts said is the most dangerous form of muscle loss, and can lead to kidney damage. Statins sometimes also damage other organs and can react with grapefruit juice or pomegranate juice. Roberts also said that women who take statins risk tendon rupture.

Fatal liver failure is rare, she said, but statins can also cause nerve damage. Case studies point to two patients who became paralyzed on statins. They did walk again, but recovery took a couple of years.

The FDA warning was not the first red flag, according to Roberts. In a 2010 Time Magazine piece, Dr. Rita Redberg asked why so many statins were being prescribed to women, since women gain even fewer benefits from them than men.

Roberts said patients should know the basics about cholesterol, which is part of every cell in the body and necessary for life. About 25 percent of the brain is cholesterol, she said, so when cholesterol’s lowered, the change can impact brain function negatively.

High low-density lipoprotein has been associated with heart attacks, Roberts said, but it’s unclear that lowering LDL actually reduces risk.

“The risk factors are high LDL and low HDL [for men],” she said.

She does become concerned when women patients have low high-density lipoprotein readings. HDL is the good cholesterol, and when it drops, it can signal danger.

“As women get older, LDL levels are really unimportant,” she said. “The most important number is HDL, and if that’s low, that’s a bad risk factor.”

Roberts blamed the confusion about cholesterol and statins, in part, on big pharmaceutical companies. Medical research used to be funded by the government’s National Institute of Health, but now the pharmaceutical companies conduct most studies.

Roberts said that the opportunity for conflict of interest is high. The companies make money from selling drugs like statins and not from urging people to exercise and eat healthy foods.

Asked if people on statins should stop taking the drugs, Roberts said that would depend on the case. Generally, if patients complained about side effects, she would recommend taking them off statins immediately.

“They don’t have to taper off,” she said. Those patients can just stop taking the drugs.

But some patients do benefit from statins, she added. For example, in people diagnosed with hereditary hypercholesterolemia, statins are necessary.

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